Stimulus Transmission and Remote Sensing System

ABSTRACT

A closed hydraulic system for transmitting a compressive force from a distal site of origin to a proximal site is disclosed. The system having a distal balloon located at the distal site, a distal transmission tube connected to the distal balloon, an exchanger connected to one end of the distal transmission tube, a proximal transmission tube connected to one end of the exchanger, and a proximal balloon connected to one end of the proximal transmission tube; the distal balloon, distal transmission tube, exchanger, proximal transmission tube and the proximal balloon, which is installed in a suitable confined space on a person and hydrostatically connected such that when the compressive force is applied to the distal balloon at the distal site, the compressive force is conveyed to the proximal balloon at the proximal site stimulating a proportional pressure sensation there in the user.

This application claims the benefit of provisional application No.62/470,543 filed 13 March, 2017.

FIELD OF THE INVENTION

The present invention generally relates to prostheses and ergonomicremote sensing systems.

BACKGROUND

The absence of distal sensation is a major limitation to function of theupper extremities, in particular, whether it is due to neurologicalimpairment or to amputation. A prosthetic socket covers part of theresidual limb that still has normal sensation, while it is providing ananchor for replacement of motor function with a mechanical terminaldevice or hand. Voluntary closing devices permit the amputee to varyforce, but with limited appreciation as to whether it is too much or toolittle to apply and sustain appropriate pinch or grasp. “The loss ofsensation in the upper limb by amputation is the greatest factorlimiting effective use of a prosthesis. A blind person cannot use anupper extremity functional prosthesis because he must rely on (visual)sensory feedback to use the hand,” Absence of sensation during thefunction of upper extremity prosthetic devices has persisted throughouttheir long history. The same sensory deficiency, during manualactivities, occurs when injury to the nerve supply of the upperextremities causes loss of motor function and sensation. Orthosesdesigned to provide as much alternative motor capability as possible,also lack a mechanism to provide sensory feedback, other than vision, tofacilitate their function.

Many prosthetic hands are comprised, superficially, of relatively densematerials which compress and conform little when grasping or pinching anobject, so the total area of the palmar surface making contact duringthese activities is limited. This structure tends to diminish theireffectiveness. The presence of some surfaces with a limited degree ofcompressibility, and/or a cosmetic glove, improve this somewhat. Thus,to alleviate these and other problems, this invention enables theamputee to utilize the residual limb's pressure sense to regulateprosthetic force and function.

These problems, and others, are addressed by the present invention anddiscussed in greater detail below.

BRIEF SUMMARY

Currently-available prostheses lack many of the proposed featuresdescribed below. With typical voluntary closing devices, the force andvelocity of the motion is determined by the strength and rate of muscleactivity that propels it. Feedback from a sensory transmitter can helpthe users to modify both speed and force. This allows for more subtleforces such as picking up an egg or maintaining a secure grip andprevent dropping.

The Stimulus Transmission and Remote Sensing system of the presentdisclosure enables pressure being applied during activities by a distalinsensitive voluntary closing prosthetic device, orthosis or tissue tobe transmitted to proximal sentient areas to enable the user to senseand adjust the distal pressure to improve function. Though finger tipshave more nerve endings and are more sensitive to some stimuli, typicalusers will not notice an appreciable difference in the pressure applieddistally or proximally.

The typical components of a Stimulus Transmission and Remote Sensing(STARS) system according to this disclosure are two small balloons, thetubes of which are connected together so their lumens communicate. Thesystem is then typically filled with a non-compressible fluid, such aswater, to become “pressure transmitter”. This is similar to a hydraulicsystem used in automotive applications. The balloon tubes are stabilizedin appropriate distal and proximal locations and when compresseddistally, during functional activities, transmit that pressure to theproximal balloon which stimulates a proportional pressure sensationthere. Due to this relayed signal ending at sentient tissue, it enablesimproved performance. Other components of the system are variable andare disclosed herein. Such variable components relate to how theballoons are connected and the methods and components used to fill thesystem with fluid and remove air, the compressibility of which wouldreduce the effectiveness of force transmission, etc. Thus, the abilityto both sense and directly vary force application provides for a higherlevel of performances that is closer to the normal operation of a humanlimb.

Functionally, the system utilizes Pascal's Law which states thatpressure applied to an enclosed fluid is transmitted equally in alldirections. A compressive pressure applied to one balloon will causeexpansion of the other. Of course, variables can change the idealizedversion of the law (typically due to fluid compression and viscosity),however such variables are minimized in this design. Thus, if a distalballoon is attached to the inner surface of a prosthetic terminal deviceor within a glove over the thumb or index finger of a prosthetic hand,for example, and the proximal balloon is located on the inner wall of aprosthetic socket over normal skin, such as the sensitive inner surfaceof the forearm, then a pressure transmitting and pressure sensationstimulating mechanism has been created. A user can be trained torecognize and associate the stimuli on his proximal surface withpressures applied on the distal prostheses.

One version of the Stimulus Transmission and Remote Sensing systemutilized two separate balloon tubes connected by a three-way stop cockto fill the system with water and evacuate air. Other, severalmodifications to such a stop cock are also disclosed to make it morecompact and suitable for function in this situation. To improve theevacuation of air while it is replaced with water, a central transparenttube-like Exchange Unit was developed in conjunction with the presentinvention. The Exchange Unit links together two separate balloon tubesby having a male connector on each of its ends link with a femaleconnector in the tube from each balloon. All components form a closedSystem filled with a non-compressible fluid, such as water. Besidesproviding a mechanism for filling the System with water and evacuatingair, the Exchange Unit enables the adjusting of pressure in, and theexpansion of, each balloon as needed.

Alternative exchange mechanisms (“exchangers”) can also be formed if twoseparate balloon tubes are joined by a “T” or ‘Y’ shaped connection, orby one with an acute angle projection. The projecting component of eachis joined to a tube which has one or two injection port(s) to fill thesystem with fluid and evacuate air.

An alternative exchanger can also be created if two balloons are joinedcontinuously to each other, during their manufacture, creating a singlecommon tube, which is then joined continuously also by a tube with aport (designated as a “one port”) or joined continuously by a “Y” shapedtube with two injection ports (designated as “V” ports) to accomplishthe exchange. A separate “T” or “Y” port could also connect to a OnePort to facilitate the replacement of air by fluid. Two injection portscan also originate directly from the common tube. Other exchangeralternatives are to have the common tube joined directly by two shorttubes, each of which can link with a syringe to receive an injection offluid while the other releases air. Each short tube has a screw cap.These two continuous tubes are separated longitudinally from each other.In one case the two tubes are located on opposite sides of the commontube and this exchanger is designated as a “180 degree offset”. In thesecond case, the two tubes are located 90 degrees “from each other andthe exchanger is designated as a “90 degree offset”.

The advantages of such an application become clear when one isexperienced in prostheses and related fields. Typical devices currentlyon the market do not have the confluence and plethora of featurescontemplated and described herein.

In a first embodiment an apparatus is disclosed, the apparatus being aprosthesis having a socket, a base, and at least one voluntary closingdevice; and at least one hydraulic signaling system each hydraulicsignaling system associated with one voluntary closing device of theprosthetic, the system having a distal balloon located on or near saidvoluntary closing device, a proximal balloon located in the socket ofthe prosthesis, and transmission tubes intermediate the proximal anddistal balloons and forming a closed hydraulic system such that acompressive force on the distal balloon is transmitted to the user atthe proximal balloon.

In another embodiment a closed hydraulic system for transmitting acompressive force from a distal site of origin to a proximal site isdisclosed, that system having a distal balloon located at the distalsite, a distal transmission tube connected to the distal balloon, anexchanger connected to one end of the distal transmission tube, aproximal transmission tube connected to one end of the exchanger, and aproximal balloon connected to one end of the proximal transmission tube,the distal balloon, distal transmission tube, exchanger, proximaltransmission tube, and proximal balloon hydrostatically connected suchthat when the compressive force is applied to the distal balloon at thedistal site, the compressive force is conveyed to the proximal balloonat the proximal site.

Such embodiments do not represent the full scope of the invention.Reference is made therefore to the claims herein for interpreting thefull scope of the invention. Other objects of the present invention, aswell as particular features, elements, and advantages thereof, will beelucidated or become apparent from, the following description and theaccompanying drawing figures.

DESCRIPTION OF THE DRAWINGS

The present invention may be better understood, and its numerousobjects, features, and advantages made apparent to those skilled in theart by referencing the accompanying drawings.

FIG. 1 is a side on view of a spherical gate exchange unit according tothe present disclosure.

FIG. 2 is a top view of the exchange unit according to FIG. 1.

FIG. 3 is a side on view of a wheel gate exchange unit according to thepresent invention.

FIG. 4 is a top view of the exchange unit according to FIG. 3.

FIG. 5 is end view of a male connector according to the presentinvention.

FIG. 6 is a cross-sectional view of a male connector according to thepresent invention.

FIG. 7 is a frontal view of a stimulus transmission and remote sensingunit installed on a trans radial prosthesis according to the presentdisclosure.

FIG. 8 is a side-view of a T-exchanger according to the presentdisclosure.

FIG. 9 is a side-view of a 1-exchanger with a Y-tube and two portsaccording to the present disclosure.

FIG. 10 is a side-view of a Y-exchanger according to the presentdisclosure.

FIG. 11 is a side-view of a Y-exchanger with a Y-tube and two portsaccording to the present disclosure.

FIG. 12 is a side-view of an acute-exchanger with one port according tothe present disclosure.

FIG. 13 is a side-view of an acute-exchanger with a Y-tube and two portsaccording to the present disclosure.

FIG. 14 is a side on view of a continuous Y-port according to thepresent disclosure.

FIG. 15 is a side on view of a continuous single or one-port accordingto the present disclosure.

FIG. 16 is a side on view of a continuous 2-port with 180 degrees offsetaccording to the present disclosure.

FIG. 17 is a side on view of a continuous 2-port with 90 degrees offsetaccording to the present disclosure.

DETAILED DESCRIPTION

Referring now the drawings with more specificity, the present inventionessentially discloses an apparatus for sensing information on andcontrolling a prosthesis. The preferred embodiments of the presentinvention will now be described with reference to FIGS. 1-17 of thedrawings. Variations and embodiments contained herein will becomeapparent in light of the following descriptions.

Looking now to FIGS. 1 & 2 a spherical gate exchanger unit 10 is shown.A typical gate exchanger 10 is comprised of e-ports 11, which can bemated to screw caps 12, threaded connectors 13, gate spindles 14, gatecontrols 15, and preferably grooves 16 located on the gate controls 15.One or more e-ports 11, may be mated with a syringe 18 which willcomprise at least a plunger 19. As may be clear, matable threadedattachments 5 can be screwed onto the thread connectors 13 for fillingballoons or other attachments.

The exchange unit 10 disclosed in FIGS. 1-2 is designed to be compactand to make evacuation of air easier and more effective than with astandard three way stop cock. These units simplify that operation andoptimize function of the system. The unit 10 is a transparent cylinderabout a half inch in diameter and, by itself, two and a half inches inlength. It contains, from a superior view of its upper surface, fromleft to right: a male connector 13, an entry-exit (e) port 11, anexternal gate control knob 15 with its underlying flow control gate, asecond e-port 11, a second gate control knob 15 with its own underlyingflow control gate and a second male connector 13. Each e-port 11 has ascrew top closure in place. Each gate control 15 knob has a longitudinalgroove 16 on its surface, the direction of which is the same as that ofits underlying gate. When the groove runs parallel to the long axis ofthe exchange unit 10, then the underlying gate is open, allowing freeflow of fluid. When the groove 16 is turned at right angles to the longaxis of the exchange unit 10, then the underlying gate 14 is closed,blocking flow, The internal gate itself may consist of a rotating spherewith a single central tubular passage from one side of the globe to theother to allow optimal flow of fluid when aligned parallel to the longaxis of the exchange unit 10.

Looking now to FIGS. 3-6 a wheel gate exchanger unit 30 is shown. Atypical gate exchanger 30 is comprised of e-ports 31, which can be matedto screw caps 32, threaded connectors 33, gate spindles 34, gatecontrols 35, and preferably grooves 36 located on the gate controls 35.One or more e-ports 31, may be mated with a syringe 18 which willcomprise at least a plunger 19. As can be seen in FIGS. 5 & 6, an endview (FIG. 5) of the male connector 33 shows wheel gate 37 partiallyclosed. A mid-line view of the male connector 33 (FIG. 6) shows anembodiment of the grooves 39 of the connectors.

The alternative gate 30 is a wheel rotating around a vertical axis andattired with an outer rubber casing layer to optimize sealing andblockage of flow or to allow flow when rotated parallel to the units 30long axis. The rubber casing can be slightly rounded on its outersurface to make rotation of the wheel easier and avoid possibledisplacement. Along the casing's inner circumference, runs a low linearmid-line peaked elevation which fits into a corresponding lineartrough-like depression around the rim of the wheel. This interconnectionalso prevents displacement of the casing during rotation of the wheelgate within the unit 30.

FIG. 7 shows an embodiment of a prosthetic limb 100 according to thepresent disclosure. A typical prosthetic 100 will comprise a hand 101which has one or more movable appendages 102. Appendages 102 are alsoknow in the art as a voluntary closing device as they allow a user tointentionally grip an object using the prosthesis. The prosthetic 100 isconnected to the patient at the limb 150 which is at the end where thelimb has been severed (often as a result of amputation). A longitudinalballoon 110 traverses from the movable appendages 102 to the limb 150which transmits the feeling of pressure from the appendages 102 to theresidual limb. Often a cuff 151 secures the location of the proximalballoons 110 relative to the limb. The cuff 151 can have a central lineof stitching 152 which separates the two proximal balloons from eachother and provides some stability. Intermediate the proximal and distalsections of the balloon 110 are transmission tubes 112. Both the tubes112 and balloons 110 are preferably filled with a non-compressible fluidsuch as water. To ensure proper filling of the balloons 110 and tubes112 an exchanger unit 115 is located intermediate the proximal anddistal sections of the balloons 110. Exchanger 115 permits separateinjection of the fluid into each balloon tube 110, evacuation of airfrom the system, and independent adjustment of the pressure in eachballoon to optimize the function of the prosthetic 100. The prosthetic100 may also have an entry slot 120 that facilitates the interfacebetween the balloons 110, tubes 112, and a removable section 121 of theprosthetic 100. Exchanger 115 may be a spherical or wheel gate exchanger(as in FIGS. 1-4) or any of another type of gate exchanger disclosedherein or known in the art.

It is preferable that the balloons 110 proximal to the limb 150 areattached beneath the wall of the prosthetic 100 or other firm surfacethat creates a counter pressure which limits outward expansion of theballoon 110 which would otherwise lead to dispersion of the force andit's under utilization for fully effective pressure transmission andstimulation. Such a location maximizes inward pressure and directs itagainst adjacent sentient skin 150. The stimulus will then beapproximately equal to pressure being applied to the balloon 110 locateddistally (adjacent movable parts 102), depending on proximal skinsensitivity. Distally, the counter pressure is supplied by theresistance of the prosthetic finger the transmitting balloon 110overlies. While other sites are contemplated, locations that are knownto be desirable for pressure sensing balloons 110 are the tips of thethumb, the index finger, the middle finger; and the front of the thumb,index, and middle fingers.

Some other surface areas 102 can also have isolated hydraulic chambers,filled with a non-compressible fluid, foam, or a compressible gas,depending on weight considerations, and serve to optimize pressuredistribution, contact area and grasp. It is preferable to ensure thatthe locations and volumes of such compartments do not overlap and makecompetitive contact during grip sufficient to increase forcerequirements and impede closure of the distal appendages 102. Someexisting prosthetic hands could be adapted to add both approaches,either by modifying their surfaces to incorporate them or by adding aglove (cosmetic or otherwise) which contains the systems distalcomponents either on, within or beneath it. The distribution of pressuretransmitting chambers distally in the hand can be duplicated proximallyto determine whether the brain can learn, as expected, with instruction,repetition and possibly some training, to identify the location ofdistal stimuli, create a new engram and thereby derive added benefitfrom further sensory information.

FIGS. 8-17 show additional types of exchangers or exchange units andports that may be utilized with different prosthetics to give properfunctionality of the limb. FIGS. 8 & 9 show illustrative T-exchangers200. In FIG. 8 a simple T-exchanger 200 and tube 201 with port 202 isshown. In FIG. 9 T-exchanger 200 is paired with a Y-tube 205 having twoports 202. FIGS. 10 & 11 show illustrative Y-exchangers 300. In FIG. 10a simple Y-exchanger 300 and tube 301 with port 302 is shown. In FIG. 11Y-exchanger 300 is paired with a Y-tube 303 having two ports 302. FIGS.12 & 13 show illustrative acute-angle-exchangers 400. In FIG. 12 asimple acute-exchanger 400 and tube 401 with port 402 is shown. In FIG.13 acute-exchanger 400 is paired with a Y-tube 403 having two ports 402.FIG. 14 shows a curved Y-Port 502 with two end ports 501. FIG. 15 showsa single port exchanger 600 which may be paired with a syringe 18. FIGS.16 & 17 show various offsets that may be contemplated between ports 601in exchange units. In a First unit 605 the ports 601 are offset by 180degrees. In a second unit 610 the ports are offset by 90 degrees. Suchangles and illustrations are illustrative in nature and do not encompassall of the possible angles and types of exchangers utilized inprostheses according to this disclosure.

INDUSTRIAL APPLICABILITY

The prosthetic 100 as shown in FIG. 7 defines a use for two connectedballoon tubes 110 for pressure transmission. This allows for thetransmission of information from distal insensitive devices 102 toproximal sentient tissue 150. Water or another similar fluid fillsballoons 110 and tubes 112 to transmit said pressure information to theuser. Use of an exchanger 115 as disclosed above aids in thetransmission of pressure.

By incorporating two entry-exit ports (as in FIGS. 1-6), an exchanger115 facilitates the evacuation of air from the system, because as wateris being injected into one port, air has a route to escape through theother, which is then capped when air evacuation is complete. Atraditional three-way stop cock does not provide this concurrent escapesite, so that any significant residual air in a water filled balloontube must be manipulated out afterwards in a separate less satisfactory,sometimes incomplete, somewhat time consuming operation by detaching theballoon tube 110, holding it vertical and squeezing or flicking it untilthe air rises and escapes, at which point the balloon tube isreattached. Residual air in the stimulus transmission and remote sensingsystem tends to diminish its efficiency in proportion to its presence,though certainly some is tolerable if sufficient useful pressuretransmission still occurs.

In isolation, when not participating in a stimulus transmission andremote sensing system, a balloon tube 110 remains, structurally, justthat. When incorporated into this system 100, however, it is convertedinto a component of a new functional entity, a pressure transmitter.

As may be clear to those skilled in the art, an advantage of the currentsystem is that it is capable of, relatively easily, being added toexisting voluntary closing prostheses or orthosis (as at 100) to providea sensory component to their function, without the cost of new devices.In this situation, pressure transmitter tubes (110, 112) can be attachedto their external surfaces by tape, covers, sheaths, staples or othermeans. An exchange unit 115 or units can be attached similarly on anexternal surface. Entry to a prosthetic socket 121 could be accomplishedby creating a wide sloped channel as at 120 through the socket wall sothe tubing 112 is not bent sharply, kinked or penetrated. Anotherpossibility, in this situation, particularly initially in existingsockets, is to create a wide loop of tubing 112 attached flatly to theouter socket wall and to enter the socket obliquely by passing over itsproximal edge continuing internally and attaching the rest of thetransmitter against the socket wall over sensitive tissues 150 on theinner surface of the forearm. For new sockets, the system would beaccommodated in initial construction Separate pre-filled pressuretransmitter units could be made available to be added to a wrist-handorthosis either by an orthotist or by an occupational therapist withintheir department. These would require a proximal cuff 121 for counterforce application. Transmission tubes 112 which cross the wrist in themiddle of its surface minimize the necessity for extra tubular length toaccommodate for wrist rotation. An even more effective alternativecrossing location for this purpose would be at or near the center of thewrist, midway between its flexor and extensor surfaces which wouldlocate the exchange unit 115 component(s) within the prosthetic socket.Internal location can be accommodated most easily within the socket ofamputees with shorter trans-radial residual limbs.

In some preferred applications, exchange units 115 can be locatedexternally just proximal to the wrist and could be contained on orwithin a cuff, with or without channels or clips to further stabilizethem. When units 115 are located externally above the wrist, a portionof the prosthetic socket proximal to this level can be made removable tofacilitate installation and access to the proximal balloon tubecomponent either on its inner surface or within appropriately designedand located pockets in a cuff that encircles the amputee's residuallimb. In most embodiments, exchange units 115 are two and a half inchesin length. There is, in addition, at each end, a small central tube,which projects one sixteenth inch beyond the body of the unit 115. Eachenters a female connector and transmits fluid. Because each such tubefunctions internally within a female connector they do not contribute tothe effective length of the exchange unit 115. Balloon tube 110connectors tend to be one inch in total length. The terminal femaleconnector section of this is a quarter inch long. Thus, the totaleffective length of an Exchange Unit and its two attached balloon tubeconnectors being four inches in some embodiments. It is theoreticallypossible that this total length be shorter, if possible, to allowoptimal space proximally for a display of balloon tube transmitters thatmatches in their size and distribution that of the origin sites of theirimpulses in the hand. It is also possible that a proximal array ofpressure transmitters 110 need not be individually of the same size, northe area of the same dimensions, for the brain to be able to interprettheir results correctly after instruction. Of note, the length of thehand in a five feet eleven inch adult male is about seven and threequarter inches and the length of the forearm is ten inches. Thus,subtracting four inches for the length of the exchange unit 115 and twofemale connectors from forearm length allows about six inches of lengthproximally for a transmitter array of pressure sensations from a distalsite.

In most embodiments the skin receptors 110 would only perceive totalforce and not its source. This requires training by the user on theapparatus 100, but can be quickly learned in some instances. Proximally,in an above elbow amputee, there is much more regular use of bulkiermuscles as the prosthetic arm is located in space by the amputee duringfunction. Nevertheless, inside the socket 121, possibly on the medialsurface, where there is less bulky muscle activity, is still apreferable location for proximal transmitters as this location alsoprovides the necessary counter force. It is possible that the brain cansort this out, by knowing the force it perceives against the socket 121during arm movement and separating it from the additional force itappreciates from the transmitter during grasp. Until this is known,proximal transmitter site selection should endeavor to avoid local forceproduction from muscle activity, as far as possible.

Accordingly, although the invention has been described by reference tocertain preferred and alternative embodiments, it is not intended thatthe novel arrangements be limited thereby, but that modificationsthereof are intended to be included as falling within the broad scopeand spirit of the foregoing disclosures and the appended drawings.

I claim:
 1. An apparatus comprising: a prosthesis having a socket, abase, and at least one voluntary closing device; and at least onehydraulic signaling system each hydraulic signaling system associatedwith one voluntary closing device of the prosthetic, the system having adistal balloon located on or near said voluntary closing device, aproximal balloon located in the socket of the prosthesis, andtransmission tubes intermediate the proximal and distal balloons andforming a closed hydraulic system such that a compressive force on thedistal balloon is transmitted to the user at the proximal balloon. 2.The apparatus of claim 1 wherein the hydraulic signaling system furthercomprises an exchange unit located intermediate the distal and proximalballoons for filling the system with an appropriate hydraulic fluid andremoving gases from the system.
 3. The system of claim 2 wherein: theprosthesis comprises more than one voluntary closing devices and eachvoluntary closing device is associated with at least one hydraulicsignaling system.
 4. The system of claim 3 wherein: the voluntaryclosing devices are fingers capable of gripping an object and the distalballoon is located on the fingertip of the fingers.
 5. The system ofclaim 4 wherein the distal balloon is a circular balloon.
 6. The systemof claim 3 wherein: the voluntary closing devices are fingers capable ofgripping an object and the distal balloon is located on the front of thefingers.
 7. The system of claim 6 wherein the distal balloon is alongitudinal balloon.
 8. The system of claim 3 the voluntary closingdevices are fingers capable of gripping an object and each of thefingers is connected to two hydraulic signaling systems, the distalballoon of a first system is located on the front of the fingers and isa longitudinal balloon, the distal balloon of a second system is locatedon the tip of the fingers and is a circular balloon.
 9. The system ofclaim 3 wherein the exchanger comprises: four threaded exchange ports;and two rotatable fluid gates.
 10. A closed hydraulic system fortransmitting a compressive force from a distal site of origin to aproximal site comprising: a distal balloon located at the distal site; adistal transmission tube connected to the distal balloon; an exchangerconnected to one end of the distal transmission tube; a proximaltransmission tube connected to one end of the exchanger; and a proximalballoon connected to one end of the proximal transmission tube, thedistal balloon, distal transmission tube, exchanger, proximaltransmission tube, and proximal balloon hydrostatically connected suchthat when the compressive force is applied to the distal balloon at thedistal site, the compressive force is conveyed to the proximal balloonat the proximal site.
 11. The system of claim 10 wherein: the distal andproximal balloons are longitudinal balloons.
 12. The system of claim 10wherein: the distal and proximal balloons are circular balloons.
 13. Thesystem of claim 10 wherein the system is filled with water.
 14. Thesystem of claim 10 wherein the exchanger comprises: a tubular body; atleast three threaded ports mounted to the body; and at least onerotatable fluid gate capable of selectively impeding fluid flow througha portion of the body.
 15. The system of claim 14 wherein the exchangercomprises: four threaded exchange ports; at least one tubular exchanger;and two rotatable fluid gates.
 16. The system of claim 15 furthercomprising: a syringe matable with one or more with the threadedexchange ports.